538. Impact of Daily Skin Cleansing of Medical Intensive Care Unit Patients with a 4% chlorhexidine gluconate (Hibiclens®) on the Incidence of Hospital acquired Multidrug Resistant Organisms
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: Patients in ICUs are often colonized and infected with multidrug resistant organisms (MDROs) such as MRSA, VRE and Acinetobacter. Standard and tight infection control practice have had limited success at controlling these pathogens. We evaluated the effectiveness of a daily skin cleansing with a 4% chlorhexidine gluconate (CHG) (Hibiclens®) in reducing MDROs in our MICU patients.
Methods: Our MICU is an 18 bed open bay unit with patients in close proximity. Since 2006, the infection control data collection and reporting has been consistent. Infection control data for the MICU is collected concurrently with clinical care and reviewed retrospectively. Our infection control practice has systematically changed. Standard precautions (SP) were in place prior July 2007 and included universal gloving and hand washing before and after patient contact. Tight infection control (TIC) has been advocated since July 2007 and includes SP, improved hand hygiene, full contact precautions, cohorting of patients with MDROs, and twice daily cleaning of all high touch surfaces. Since July 2008, daily skin cleansing with a 4% CHG (Hibiclens®) in addition to TIC has been instituted. Quarterly aggregates for each organism are reported (average±SD).
Results: The quarterly incidence of MICU patients colonized and/or infected with MDROs appears to decrease as our infection control practice progressed. BSI also appeared to decrease from SP to TIC and this decrease persisted with TIC with CHG.
Conclusion: Progression of infection control practice from SP to TIC to TIC with CHG was associated with a decrease in MICU patients colonized and/or infected with MDROs. This data would support additional, multicenter trials evaluating the addition of CHG to tight infection control practices.
MDRO Infections
MRSAMRSA BSIVREVRE BSIAcinetoAcineto BSI
SP group8.22.61.80.48.23.45.72.216.57.52.72.8
TIC group7.04.31.01.46.00.83.31.910.53.70.81.0
CHG group6.32.10.70.65.03.63.31.97.33.21.01.0
Heather Beitz, BS1, Galo Cubillos, MD2, Alan Hartstein, MD3, Daniel H. Kett, MD, LaToya Lewis-Pierre, RN, MSN5, Ron Motiram, BA, MBA1, Madelaine Tamayo, RN, MSM5 and  D. H. Kett,
Molnlycke Healthcare Role(s): Research Relationship, Received: Research Support.
M. Tamayo, None..
G. F. Cubillos, None..
L. Lewis-Pierre, None. 
R. Motiram,
Molnlycke Healthcare Role(s): Employee, Received: Salary.
H. Beitz,
Molnlycke Healthcare Role(s): Employee, Received: Salary.
A. I. Hartstein, None., (1)Molnlycke Healthcare, Norcross, GA, (2)Miller School of Medicine at the University of Miami, Miami, FL, (3)JMH, (4)Jackson Health Systems, Miami, FL